Nomograms to predict naming decline after temporal lobe surgery in adults with epilepsy

Author:

Busch Robyn M.,Hogue Olivia,Kattan Michael W.,Hamberger Marla,Drane Daniel L.,Hermann Bruce,Kim Michelle,Ferguson Lisa,Bingaman William,Gonzalez-Martinez Jorge,Najm Imad M.,Jehi Lara

Abstract

ObjectiveTo develop and externally validate models to predict the probability of postoperative naming decline in adults following temporal lobe epilepsy surgery using easily accessible preoperative clinical predictors.MethodsIn this retrospective, prediction model development study, multivariable models were developed in a cohort of 719 patients who underwent temporal lobe epilepsy surgery at Cleveland Clinic and externally validated in a cohort of 138 patients who underwent temporal lobe surgery at one of 3 epilepsy surgery centers in the United States (Columbia University Medical Center, Emory University School of Medicine, University of Washington School of Medicine).ResultsThe development cohort was 54% female with an average age at surgery of 36 years (SD 12). Twenty-six percent of this cohort experienced clinically relevant postoperative naming decline. The model included 5 variables: side of surgery, age at epilepsy onset, age at surgery, sex, and education. When applied to the external validation cohort, the model performed very well, with excellent calibration and a c statistic (reflecting discriminatory ability) of 0.81. A second model predicting moderate to severe postoperative naming decline included 3 variables: side of surgery, age at epilepsy onset, and preoperative naming score. This model generated a c statistic of 0.84 in the external validation cohort and showed good calibration.ConclusionExternally validated nomograms are provided in 2 easy-to-use formats (paper version and online calculator) clinicians can use to estimate the probability of naming decline in patients considering epilepsy surgery for treatment of pharmacoresistant temporal lobe epilepsy.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical)

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1. Epilepsy and Neuropsychology;Neurologic Clinics;2024-06

2. Predictive models of epilepsy outcomes;Current Opinion in Neurology;2024-01-15

3. Impact of white matter networks on risk for memory decline following resection versus ablation in temporal lobe epilepsy;Journal of Neurology, Neurosurgery & Psychiatry;2024-01-11

4. Dominant, Lesional Temporal Pole Epilepsy;Epilepsy Surgery: A Practical Case-Based Approach;2024

5. Sex differences in the pre and postoperative neuropsychological function of epilepsy surgery candidates;The Clinical Neuropsychologist;2023-11-17

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